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DISCOVERING HIDDEN RESOURCES

Assistive Technology Recycling, Refurbishing, and Redistribution
RESNA Technical Assistance Project
April 2000


CHAPTER 4



Assistive Technology Recycling Efforts Around the Globe
With a wealth of surplus assistive technology, many recycling projects want to help people with disabilities in other countries. What is the best way for programs to help these individuals and what is the best way to supplement assistive technology?

Several models of recycling programs fill unique needs in other countries. The East West Foundation (EWF) provides computers. Another project, Whirlwind Wheelchairs International (WWI), provides assistance with mobility devices. The International Medical Equipment Collaborative (IMEC), which has strong assistance from Rotary Clubs worldwide, provides specialized medical equipment.

Recycling Meets a Variety of Needs
The decision to supply assistive technology to individuals in another country is based on the project's goal, which is meeting the unique needs of people in a country or region. To determine the goal, specific questions must be asked. Is the need for assistive technology a short-term one? Is there a need for highly specialized equipment that cannot be produced locally? Or is the need a chronic one that could be solved best through a long-term solution?

Short-term. If the need is a short-term one, that is, assistive technology is needed on an emergency basis because of war or a chaotic economic situation, then AT may be provided best through direct shipments of various technology from a recycling program to the country or community for the duration of the time period. Programs such as the New Hampshire REM and FODAC provide AT, such as walkers and wheelchairs, upon request, to fill immediate needs of individuals in other countries. They also can provide replacement parts that will last for the short term, until more permanent solutions can be explored.

Specialized Equipment. If a country needs specialized equipment, such as medical equipment or computer technology, a process can be started to meet these needs. For example, IMEC works with humanitarian organizations to identify the sites in a country, such as a hospital in Romania or a community clinic in Ethiopia, that have specialized needs. These sites then become projects for IMEC. For each site, IMEC conducts a comprehensive assessment of its needs and then works to meet the needs over a period of time through phased shipments of equipment and visits from experts.

Computer technology, because of its complexity, can be considered specialized equipment. The EWF works with partner organizations both in this country and in developing countries to determine what the local needs are and the purpose for using the technology. It then delivers the specified computers, trains the users, and provides technical support to ensure that the identified need is filled.

Long-term. If the needs are long term, then they may be filled best with locally produced technology that can be maintained locally. WWI works with groups of wheelchair users throughout the world, helping them identify wheelchair designs that fit their rugged terrain. These chairs can be made with inexpensive, locally available materials; these chairs also can be repaired easily and inexpensively. This use of appropriate technology for an individual's living conditions can lead to a long-term solution to filling assistive technology needs in developing countries.

Program Operations
International recycling programs often work with partner organizations to funnel equipment donations and volunteer help, and to identify countries and areas with needs. Funding is received through grants from sponsors interested in the projects. One such funder is the Rotary Club, with its matching funds for international programs. Rotary works closely with IMEC to provide enough resources to ensure that shipments of specialized equipment get to their destinations and are installed and used properly. Rotary has a diverse set of resources, both monetary and member expertise, which it offers to other recycling programs that need assistance.

WWI also works with partner groups in developing countries. It helps to empower local individuals and groups. It works to validate ideas and spread them to others around the world. WWI also provides technical services to local designers and builders, provides state-of-the-art product testing, and supplies research findings that can, in turn, be funneled back to the local designers in developing countries.

Assistance to Fill Greatest Need

International Medical Equipment Collaborative
The International Medical Equipment Collaborative (IMEC), established 4 years ago as a nonprofit organization, provides new and reconditioned medical equipment, training, and ongoing support to hospitals around the world. IMEC's goal is to raise the standard of health care for countries that have the greatest need.
"We provide needed medical tools to some of the poorest hospitals, clinics, and orphanages in the world," said Tom Keefe, President of IMEC. "At present we are shipping once a week. We have 50 active volunteers and 50 volunteers on call. Our goal by the end of the year 2000 is to ship out a phase of a project every day, and to have 200 active volunteers and 100 volunteers on call."

IMEC learns about the facilities that are in need through the partner organizations with which it works. These "shepherding" organizations identify sites where IMEC will work. IMEC sees its mission as assisting doctors and nurses in these settings as they care for the sick and injured. Each site that is selected is called a project. Each phase of a project entails a shipment of needed medical items. These shipments occur over several years. IMEC also provides training to use the equipment and offers ongoing support.

"It is our belief that this approach will have a long-term impact on the standards of care in these hospitals, clinics, and orphanages," said Keefe.

Volunteers provide substantial contributions to the organization. They conduct an assessment of each site. A team of volunteers travels to the selected site and learns about the needs of the hospital and clinic. Volunteers also help staff the installation team that assists in unloading the equipment and in making the medical items operational.

IMEC successfully collaborates with other organizations. A prime partner is the Rotary. According to Keefe, Rotary clubs in his area work with affiliate Rotary clubs in the countries in which IMEC works. Local club members volunteer at the distribution center in Seabrook, New Hampshire, and they participate in on-site assessments in different countries. Rotarians are also members of installation teams, who assist when equipment is delivered overseas. The Rotary has been instrumental in finding needed resources-both people and products.

Contact Information
International Medical Equipment Collaborative
Tom Keefe, President
POB 1619, 239 Walton Road
Seabrook, NH 03874
(603) 474-4166

Powerful Partners
Rotary International
Rotary International is a service organization that was started in 1905 by Paul Harris. Today, there are 1.2 million members in nearly 30,000 Rotary clubs located in 187 countries and territories. Rotarians can be powerful partners for recycling projects "because they have a ready force of volunteers," said John Sheridan, Rotary District Governor from Bow, New Hampshire. "They have people who are geared to humanitarian projects and have knowledge about a wide variety of things."

There are several advantages to partnering with Rotary clubs. Clubs in the U.S. work not only with people in their local areas but throughout the world. Overseas Rotary Clubs offer tremendous connections for U.S. clubs in assisting people in other countries. These connections are the key to success in Rotary's quest to eliminate polio around the globe. "Rotary took on the challenge a few years back to eradicate polio from the face of the earth by the year 2000," Sheridan said. "We're almost there because we have a widespread organization throughout the world with local club members who could convince their neighbors that it is okay to give their babies the vaccine."

Currently Rotary spends about $158 million annually in humanitarian projects. "Money is leveraged very, very quickly," Sheridan pointed out, primarily through a matching grants process. Local clubs contribute funds and then a district governor matches them for international projects. The Rotary Foundation of Rotary International then matches with additional funds.

Rotary also can offer innovative strategies to some of the issues facing recycling programs, such as reducing costs of shipping and transporting equipment. For example, in the aftermath of Hurricane Mitch, Rotary clubs in New Hampshire sent supplies to Honduras through free trucking services. First, Rotary asked a trucking company that had scheduled a truck to return to New Orleans from New Hampshire with no cargo if it could carry relief supplies. Rotary then contacted Chiquita Banana Corporation, which carried the supplies from New Orleans to Honduras free of charge.

Across the United States, local Rotary Clubs continually are looking for projects, primarily in four areas: club service, vocational services, community service, and international service. Sheridan urged anyone who could use services from the Rotary to contact a club in their area.

Contact Information
New Hampshire Rotary
John Sheridan, District Governor
55 Albin Road
Bow, NH 03304-3703
(603) 224-9749

Access to Information, Access to the World

East West Foundation
The East West Foundation (EWF) is a nonprofit that recycles computer technology. EWF was started 10 years ago through two grants funded by the federal government to provide refurbished computer technology to nongovernmental organizations in emerging republics of the former Soviet Union. This humanitarian effort was an attempt to improve relations between America and Eastern Europe. This effort began at a time when U.S. companies were trading up to the next generation of technology and there were many surplus computers. Later the foundation's mandate was expanded to include Africa, Latin America, and Central America.

In 1995 the federal grant ended. At that time, about 80% of EWF's business was international and 20% was domestic. For the last five years EWF has refocused on local communities. It began recycling computers in the Boston area, then throughout Massachusetts and New England. At this time, about 80% of EWF's business is targeted to the U.S. although it still fills international requests. Current international projects include Kenya, Croatia, Honduras, Nigeria, Senegal, Angola, and South Africa.

As a nonprofit organization, EWF covers its costs by fundraising and selling technology that is refurbished for reuse. It refurbishes 3,500 to 4,000 systems per year, primarily 486 generation computers. New Deal Software, a sophisticated software with applications that can run on low-end machines, is loaded onto the computers. A 486 computer sells for $250. This price includes 4 to 6 hours of basic computer literacy training for every family.

EWF works primarily with organizations, schools, and nonprofit agencies. Training is conducted in partnership with community-based organizations that know the families that need this technology. To help provide basic computer literacy, EWF trains the organization's staff members who in turn train families. "Providing that training and technical support, even on the most basic level, is critical to the success of providing this important technology to families," said Stephen Farrell, President of EWF.

"Access to technology means access to information and access to the world. Access is critical in both educational and personal areas. To be able to communicate, to be able to find out information, that's what this computer stuff is all about. That's what getting onto the Internet is all about," Farrell said.

Contact Information
East West Foundation
Stephen Farrell, President
504 Dudley St.
Roxbury, MA 02119
(617) 442-7448
Web site: http://www.eastwest.org

Local Production for Long-Term Solutions

Whirlwind Wheelchair International
American wheelchairs exported for use in developing countries fail and become useless in a short time because of the unpaved roads and bumpy surfaces in most overseas countries. "Most present wheelchair designs won't even cross a rutted dirt road. They are too unstable. Their traction and handling aren't good enough," said Ralf Hotchkiss, Technical Director of Whirlwind Wheelchair International.

To build better, more rugged wheelchairs than the standard American variety, many wheelchair users in developing countries are taking matters into their own hands. They are designing and building their own chairs in a way that will allow the chairs to withstand rough surfaces and to be serviced easily. They know that gifts of secondhand wheelchairs from the U.S. are not the answer. The U.S. chairs, while a first start, are not a viable, long-term solution.

Funds from USAID to the Nicaraguan Independent Living Center initiated the Whirlwind Wheelchair International Project in 1982 for the manufacturing of locally produced wheelchairs. The center's work was started by four teenagers who had shared one wheelchair. They used the chair on unpaved roads and rough terrain and the chair would break down. The teens became skilled mechanics by figuring out how and why it had failed. They chopped and lowered the chair, narrowed it, and reinforced it to the point where it really did run well.

Working with Hotchkiss, the Nicaraguans went on to develop their own design, the Whirlwind Wheelchair. The Whirlwind Wheelchair is a simple, folding wheelchair, which weighs 35 lbs. instead of 50 lbs. for a standard chair. This lightweight chair can be made in one week by one mechanic at a cost of $60 to $100 for materials.

"Today wheelchairs are being made in 25 countries all around the Third World. About 15,000 chairs have been made and that is only the tip of the iceberg. Easily 20 million are needed today. Nearly 99% of the people in the Third World who need wheelchairs have nothing to ride," said Hotchkiss.

Whirlwind Wheelchair International has helped identify good design solutions and passed that knowledge on through a network of local wheelchair manufacturers in developing countries. For example, ball bearings are a key component for the smooth ride of a wheelchair, but are expensive. A solution was adapted from a bearing invented by a U.S. farmer in Appalachia. It uses common nails with the heads cut off to produce a needle bearing (16 penny nails on a 5/8 inch axle). This bearing is strong and lasts 5 years with limited maintenance. Twelve regular bearings for one chair would cost $100 in Nicaragua. This needle bearing costs only $1.

Wheels imported from other countries commonly break down. The cost of replacement rear wheels ($125 to $300) bought in the United States is more than the cost of an entire wheelchair in developing countries. Rubber wheels for the front of the Whirlwind were adapted from a Zimbabwe push cart design. These wheels are molded rubber with a deep indentation on both sides, and were made originally as very wide wheels. These wheels are very flexible; they "walk" over rocks and never go flat. They can be made in any auto tire retread shop and last in excess of 10 years because of flexibility and the high abrasion resistance of auto tire retread rubber.

Another critical concern is preventing pressure sores from developing in those individuals with spinal cord injuries who use wheelchairs. The development of pressure sores is an enormous problem for those who use wheelchairs and for those confined to bed. Worldwide, most people with spinal cord injuries, who are confined to bed, die of pressure sores within a year. Even after a person receives a wheelchair, pressure sores from improper or a lack of cushioning continue to be a life-threatening problem, as chronic infections often result from the sores. American cushions are of little use because they often go flat and there are no spare parts available.

Because there are few survivors of spinal cord injuries in many developing countries, the critical mass of active survivors needed for peer support, and to pass on information to each other and the medical profession about improving wheelchair cushions, does not exist. Fortunately, in a handful of countries, a small number of people with spinal cord injuries have been developing low cost seat cushions. One cushion base design that has been successful is made from 15 layers of corrugated cardboard that are cut, moistened with water, and molded like paper mache to the person's shape. A blanket or foam cushion is placed on top of the cardboard base.

Women in developing countries have become active wheelchair designers. They have designed chairs that are more functional for childcare and work requirements, such as vegetable farming, and for working on the ground, for those with limited furniture and no tables on which to work. Their chair designs tend to be more stable and more capable of carrying goods and tools than the wheelchairs designed for men in their countries.

The staff at San Francisco State University provide training and technical support to local wheelchair designers. They identify good ideas from all over the world, conduct tests on them, and make them available to other people.

"If the level of support and the level of capital that's required to get American wheelchairs down to Third World countries were put into helping people make their own chairs, then they could make chairs that really work," said Hotchkiss.

Contact Information
Whirlwind Wheelchair International
Ralf Hotchkiss, Technical Director
East Bay Office and Workshop
6506 Farallon Way
Oakland, CA 94611
(510) 547-2704


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The RESNA Technical Assistance Project, Grant #H224A50006, is an activity funded by the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education (ED), under the Technology-Related Assistance for Individuals with Disabilities Act of 1988, as amended. The information contained herein does not necessarily reflect the position or policy of NIDRR/ED or the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), and no official endorsement of the materials should be inferred.

RESNA is an interdisciplinary association of people with a common interest in technology and disability. RESNA is the grantee funded under the Tech Act to provide technical assistance and information to the Tech Act projects.


The National Assistive Technology Technical Assistance Partnership is a cooperative agreement between the U.S. Department of Education and RESNA. The grant (Grant #H224B050003; CFDA 84.224B) is funded under the Assistive Technology Act of 1998, as amended and administered by the Rehabilitation Services Administration, Office of Special Education and Rehabilitative Services at the U.S. Department of Education.

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